Rumination in posttraumatic stress disorder: a systematic review

Michelle L. Moulds*, Madelyne A. Bisby, Jennifer Wild, Richard A. Bryant

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

51 Citations (Scopus)


Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.

Original languageEnglish
Article number101910
Pages (from-to)1-16
Number of pages16
JournalClinical Psychology Review
Early online date11 Sept 2020
Publication statusPublished - Dec 2020
Externally publishedYes

Bibliographical note

Copyright © 2020 Elsevier Ltd. All rights reserved.


  • rumination
  • repetitive thinking
  • PTSD
  • trauma


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